Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland最新文献_第10页

The impact of direct consultant-to-consultant referrals on the spinal care pathway: A clinical audit 直接咨询师到咨询师转诊对脊柱护理途径的影响：临床审计。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-05-26 DOI: 10.1016/j.surge.2025.05.001

Arnav Barve , Paul McCarroll , Kevin Clesham , Harry Marland , Jake M. McDonnell , Stacey Darwish , Marcus Timlin , Sam Lynch , Seamus Morris , Joseph S. Butler , Keith Synnott

Background

The institution in focus is a tertiary referral centre for all spinal pathology in the country. Traditionally, referrals to this centre have been reviewed by an on-call resident at the referring hospital. However, on May 10, 2023, this changed to a direct consultant-to-consultant referral protocol. This study aims to evaluate the impact of this change in protocol on the spinal care pathway.

Methods

A retrospective review was conducted based on patients with spinal pathology referred to the tertiary centre from February 2023 to August 2023. Referrals made using the traditional referral system (‘Before’ from 08/02/2023–09/05/2023) were compared to referrals made through the consultant-led referral system (‘After’ from 10/05/2023–08/08/2023). Parameters such as the number of referrals, number of surgically managed patients, and patients with complete imaging at the time of referral (TOR) were statistically compared between the groups.

Results

There were 31.2 % fewer referrals in the ‘After’ group (223) than in the ‘Before’ group (324). The proportion of patients with complete imaging at TOR increased significantly (67.3 % vs. 81.6 %, p < 0.05). Also, the number of patients who were treated surgically increased significantly (33.3 % vs. 40.4 %, p < 0.05). Furthermore, the number of patients referred for follow-up to the outpatient department (OPD) decreased significantly (5.2 % vs. 0.9 %; p < 0.05).

Conclusion

The consultant-to-consultant referral protocol decreased the overall referral numbers, increased the number of patients with complete imaging, increased the surgical yield, and decreased the rates of OPD follow-up. This can be attributed to more efficient consultant-led local decision-making, which fortifies the benefits of this referral protocol.

背景：重点机构是三级转诊中心所有脊柱病理在该国。传统上，转诊到本中心的病人由转诊医院的一名随叫随到的住院医生进行复查。然而，在2023年5月10日，这改为直接咨询师对咨询师的推荐协议。本研究旨在评估这一方案改变对脊柱护理途径的影响。方法：对2023年2月至2023年8月在第三中心就诊的脊柱病理患者进行回顾性分析。使用传统转介系统（208/02/23 -09/05/2023）的转介个案与使用顾问转介系统（208/05/2023 -08/08/2023）的转介个案进行比较。转诊人数、手术处理患者人数、转诊时影像完整的患者（TOR）等参数在两组间进行统计学比较。结果：“治疗后”组（223例）比“治疗前”组（324例）少31.2%。结论：医师对医师的转诊方案减少了总体转诊人数，增加了完整影像的患者数量，提高了手术成功率，降低了OPD随访率。这可归因于更有效的顾问领导的地方决策，这加强了这种转诊协议的好处。

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引用次数: 0

Small bowel obstruction secondary to peritoneal tuberculosis: A case report 腹膜结核继发小肠梗阻1例。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-05-23 DOI: 10.1016/j.surge.2025.04.027

Marcus James Renshaw, Pete John Webster

Extrapulmonary Tuberculosis (EPTB) can affect many organ systems, including the gastrointestinal (GI) tract. Here, it may manifest as intestinal, peritoneal, hepato-pancreato-biliary TB, or as TB lymphadenitis. We report a case of small bowel obstruction secondary to peritoneal TB deposits in a patient who had previous received BCG vaccination. The patient was managed with emergency laparotomy and received TB treatment post-operatively. This article highlights the innocuous presentation of peritoneal TB and difficulties obtaining a diagnosis. Furthermore, we review the efficacy of the BCG vaccine and remind the reader of the importance of a travel history in the acute abdomen setting.

肺外结核（EPTB）可影响许多器官系统，包括胃肠道。结核可表现为肠结核、腹膜结核、肝-胰-胆道结核或结核淋巴结炎。我们报告一例小肠梗阻继发于腹膜结核沉积的病人谁曾接受过卡介苗接种。患者接受了紧急剖腹手术，并在术后接受了结核病治疗。本文强调腹膜结核的无害表现和难以获得诊断。此外，我们回顾了卡介苗的功效，并提醒读者在急腹症背景下旅行史的重要性。

引用次数: 0

Fit for Purpose: Does radiation personal protective equipment provision match the requirements of our trauma and orthopaedics surgical workforce? 适合用途：放射个人防护设备的供应是否符合创伤和矫形外科工作人员的要求？

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-05-17 DOI: 10.1016/j.surge.2025.04.028

Hannah Sevenoaks , Joanna Richards , Sophie Howles , Louise McMenemy , Robyn Brown , Lorraine Murphy , Deepa Bose , David S. Johnson , North West Orthopaedic Research Collaborative , West Midlands Orthopaedic Research Collaborative , Wessex Orthopaedic Learning Forum , Bristol Orthopaedic Registrars Group

Introduction

The use of ionising radiation for fluoroscopic interventions is widespread across many surgical specialities. Employers have a legal responsibility to ensure healthcare workers are appropriately protected from this hazard, with one component of this being provision of radiation personal protective equipment (PPE).

Methods

Independent studies were undertaken across four regions of England in 2023 (North West (NW), Wessex, West Midlands and Severn) in 35 hospital trusts to catalogue and evaluate radiation PPE provision in theatres. Size and appropriateness of radiation PPE for surgeon use (i.e. wrap-around protection and ≥0.25 mm lead weight equivalence (LWE)) was correlated with size requirements of the workforce.

Results

For all radiation PPE in orthopaedic theatres 67.4 % (n = 844/1253) did not meet the standard of providing 0.25 mm LWE wrap around torso protection. Approximately one third (33.9 %) of all surgeons (n = 294/865) in NW, Wessex or West Midlands were unable to access a wrap around gown of size appropriate to them. We found a mismatch in the size of the radiation PPE provision and the size requirements of all surgeons irrespective of gender, which particularly affected those using the larger and smaller sizes of gown.

Conclusions

Provision of radiation PPE for orthopaedic surgeons across four large regions of England is inadequate. We encourage all trusts and surgeons to appraise their current provision.

导读：电离辐射在透视治疗中的应用已广泛应用于许多外科专科。雇主有法律责任确保卫生保健工作者受到适当保护，免受这种危害，其中一个组成部分是提供辐射个人防护设备（PPE）。方法：于2023年在英格兰四个地区（西北（NW），威塞克斯，西米德兰兹和塞文）的35家医院信托基金中进行了独立研究，以编目和评估手术室的辐射PPE供应。外科医生使用的辐射防护用品的尺寸和适当性（即环绕保护和≥0.25 mm铅重当量（LWE））与工作人员的尺寸要求相关。结果：在所有骨科手术室中，67.4% （n = 844/1253）的放射防护用品不符合提供0.25 mm LWE包裹躯干保护的标准。在西北、威塞克斯或西米德兰兹，大约三分之一（33.9%）的外科医生（n = 294/865）无法获得适合他们尺寸的裹身衣。我们发现辐射防护用品的尺寸与所有外科医生的尺寸要求不匹配，而不考虑性别，这尤其影响到那些使用较大和较小尺寸的手术服的人。结论：在英格兰的四个大地区，为骨科医生提供辐射PPE是不够的。我们鼓励所有的信托和外科医生评估他们目前的规定。

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引用次数: 0

List of editors 编辑人员名单

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-05-16 DOI: 10.1016/S1479-666X(25)00104-0

引用次数: 0

Call Yourself a Surgeon? The use of the title surgeon among non-surgical cosmetic practitioners in the United Kingdom 自称外科医生？头衔外科医生的使用在英国的非手术美容从业人员。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-05-14 DOI: 10.1016/j.surge.2025.04.050

James Olding , Rohan Shankarghatta , Bachun Cheema , Nafeesa Hussain , Hassan Hussain , Alessandra Kuhn Dall’Magro , Ashraf Messiha

Background

The global growth in cosmetic procedures has generated ongoing debate around what constitutes a medical procedure. Non-surgical procedures account for the majority of all cosmetic treatments performed, however in many jurisdictions, regulatory frameworks have not kept pace. In the United Kingdom, the term surgeon has partial protection in law in a medical context, being restricted to medical doctors registered with the General Medical Council (GMC). UK law thus permits all medically qualified doctors to call themselves surgeons. This sets up a conflict with multiple Codes of Conduct and Regulatory guidance documents, which set out clear definitions of what constitutes a surgeon.

Methods

We conducted a review of a public database including 350 non-surgical aesthetics doctors, identifying, practitioners presenting as surgeons. Information was checked against the GMC register, and guidance form Advertising Standards Authority Guidance and the Royal College of Surgeons of England.

Results

We found that 62 % of practitioners presenting as surgeons did not meet the identified criteria in regulatory guidance. These consisted in practising surgeons without specialist registration (equivalent to board certification), hair restoration surgery practitioners, and practitioners solely offering non-surgical treatments.

Discussion

Collaborative dialogue across surgical and medical aesthetics sectors is needed to agree accepted terminology in medical and surgical aesthetics practice. This is crucial to both empower patient choice and to allow aesthetics practitioners to meaningfully convey their previous experience and training, which may have been in a surgical setting. Doctors who have not undertaken surgical training should avoid terminology that could confuse patients.

背景：整容手术的全球增长引发了关于什么是医疗程序的持续争论。非手术程序占所有美容治疗的大多数，但在许多司法管辖区，监管框架没有跟上步伐。在联合王国，“外科医生”一词在医疗方面受到法律的部分保护，仅限于在总医学委员会（GMC）注册的医生。因此，英国法律允许所有有医学资格的医生称自己为外科医生。这与多个行为准则和监管指导文件产生了冲突，这些规范和指导文件明确定义了什么是外科医生。方法：我们对一个公共数据库进行了回顾，其中包括350名非手术美学医生，确定从业人员以外科医生的身份出现。这些信息是根据GMC注册、广告标准局指导和英国皇家外科医生学院的指导进行检查的。结果：我们发现62%的医生以外科医生的身份出现，不符合监管指导中确定的标准。这些包括没有专科注册（相当于委员会认证）的执业外科医生、头发修复手术从业员，以及只提供非手术治疗的从业员。讨论：需要在外科和医学美学部门之间进行协作对话，以商定医学和外科美学实践中接受的术语。这对于赋予患者选择权和允许美学从业者有意义地传达他们以前的经验和训练至关重要，这些经验和训练可能是在手术环境中进行的。没有接受过外科训练的医生应避免使用可能混淆患者的术语。

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引用次数: 0

Wire-guided localisation vs HOLOGIC® LOCalizer™ radiofrequency identification (RFID) tag localisation of non-palpable breast lesions; a comparative analysis of ease of use and accuracy of localisation 导线引导定位与HOLOGIC®LOCalizer™射频识别（RFID）标签对不可触及乳房病变的定位；定位的易用性和准确性的比较分析。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-05-08 DOI: 10.1016/j.surge.2025.04.052

Gordon R. Daly , Eman Hamza , Sneha Singh , Rory Patterson , Caoimhe Hassett , Sandra Hembrecht , Emily Crilly , Aoife O'Brien , Eithne Downey , Aisling Hegarty , Neasa Ní Mhuircheartaigh , Colm Power , Nuala A. Healy , Deirdre Duke , Arnold D.K. Hill

Background

Breast cancer screening programs have increased the detection of nonpalpable breast lesions. Given its accuracy and low failure rate, wire-guided localisation has long been the gold-standard prior to breast conserving surgery (BCS). Recently, several non-invasive localisation modalities have been developed, with varied efficacy reported. This study aimed to evaluate tag localisation's impact on margin positivity and re-excision rates and utility in management of benign lesions compared to wire-guided localisation.

Methods

A retrospective comparative study was performed of patients, who underwent wide local excision (WLE) from 2020 to 2023, in a single institution. Descriptive statistics were performed on patient, tumour and radiological findings. Binary regression analysis was used to assess the association between localisation techniques and margin positivity and re-excision rates.

Results

Of 680 patients included, 123 (18.1 %) underwent tag localisation, 298 (43.8 %) underwent ultrasound (US) guided wire localisation and 259 (38.1 %) underwent mammogram (MG) guided wire localisation. Tag localisation was associated with a significantly lower rate of positive margins compared to wire guided localisation (p < 0.03). While not statistically significant, a trend towards lower re-excision rates was observed post tag localisation (11.24 %) compared to both US guided wire localisation (18.99 %) and MG guided wire localisation (20.66 %). However, tag localisation was significantly more likely to fail and require a subsequent wire (0 = 0.0003).

Conclusion

While associated with fewer positive margins, tag localisation did not significantly lower re-excision rates and was more likely to fail than wire-guided localisation. Further studies may elucidate its possible benefits in select patients.

背景：乳腺癌筛查项目增加了对不可触及的乳腺病变的检测。由于其准确性和低失败率，导线引导定位一直是保乳手术（BCS）之前的金标准。最近，几种非侵入性定位方式被开发出来，疗效不一。本研究旨在评估与线导定位相比，标签定位对边缘阳性和再切除率的影响以及在良性病变管理中的效用。方法：对2020年至2023年在同一医院行广域局部切除（WLE）的患者进行回顾性比较研究。对患者、肿瘤和放射学结果进行描述性统计。二元回归分析用于评估定位技术与切缘阳性和再切除率之间的关系。结果：在680例患者中，123例（18.1%）进行了标签定位，298例（43.8%）进行了超声（US）引导线定位，259例（38.1%）进行了乳房x光片（MG）引导线定位。与线导定位相比，标签定位与明显较低的阳性边缘率相关(p结论：虽然与较少的阳性边缘相关，但标签定位并没有显著降低再切除率，而且比线导定位更容易失败。进一步的研究可能会阐明它在特定患者中的可能益处。

{"title":"Wire-guided localisation vs HOLOGIC® LOCalizer™ radiofrequency identification (RFID) tag localisation of non-palpable breast lesions; a comparative analysis of ease of use and accuracy of localisation","authors":"Gordon R. Daly , Eman Hamza , Sneha Singh , Rory Patterson , Caoimhe Hassett , Sandra Hembrecht , Emily Crilly , Aoife O'Brien , Eithne Downey , Aisling Hegarty , Neasa Ní Mhuircheartaigh , Colm Power , Nuala A. Healy , Deirdre Duke , Arnold D.K. Hill","doi":"10.1016/j.surge.2025.04.052","DOIUrl":"10.1016/j.surge.2025.04.052","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer screening programs have increased the detection of nonpalpable breast lesions. Given its accuracy and low failure rate, wire-guided localisation has long been the gold-standard prior to breast conserving surgery (BCS). Recently, several non-invasive localisation modalities have been developed, with varied efficacy reported. This study aimed to evaluate tag localisation's impact on margin positivity and re-excision rates and utility in management of benign lesions compared to wire-guided localisation.</div></div><div><h3>Methods</h3><div>A retrospective comparative study was performed of patients, who underwent wide local excision (WLE) from 2020 to 2023, in a single institution. Descriptive statistics were performed on patient, tumour and radiological findings. Binary regression analysis was used to assess the association between localisation techniques and margin positivity and re-excision rates.</div></div><div><h3>Results</h3><div>Of 680 patients included, 123 (18.1 %) underwent tag localisation, 298 (43.8 %) underwent ultrasound (US) guided wire localisation and 259 (38.1 %) underwent mammogram (MG) guided wire localisation. Tag localisation was associated with a significantly lower rate of positive margins compared to wire guided localisation (p < 0.03). While not statistically significant, a trend towards lower re-excision rates was observed post tag localisation (11.24 %) compared to both US guided wire localisation (18.99 %) and MG guided wire localisation (20.66 %). However, tag localisation was significantly more likely to fail and require a subsequent wire (0 = 0.0003).</div></div><div><h3>Conclusion</h3><div>While associated with fewer positive margins, tag localisation did not significantly lower re-excision rates and was more likely to fail than wire-guided localisation. Further studies may elucidate its possible benefits in select patients.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 4","pages":"Pages 248-253"},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Does cross-sectional imaging diminish the utility of surgical handover for trainee assessment? 横断成像是否削弱了手术交接对实习生评估的效用？

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-05-07 DOI: 10.1016/j.surge.2025.04.053

Liam Costello, Conor Toale, Farah Mohammed, Paul F. Ridgway

Introduction

Workplace-based assessments have been widely adopted by surgical training bodies to assess surgical trainees. In this study, we used a handover tool to assess the diagnostic accuracy of admitting surgical trainees, and whether this was impacted by cross-sectional imaging.

Methods

Data was retrospectively reviewed from a prospectively maintained database. Details of 979 patients over a 7-month period were reviewed. The primary outcome was concordance between the admitting and discharge diagnoses, as recorded using the surgical handover tool.

Results

The concordance between the admitting and discharge diagnoses was 81.4 %. A positive association was found between diagnostic accuracy and pre-referral cross-sectional imaging (r = 0.67). Obtaining a CT scan before handover was significantly associated with higher diagnostic accuracy (p < 0.0001).

Conclusion

Cross-sectional imaging positively affects the diagnostic accuracy of surgical trainees. Given the availability of cross-sectional imaging, this calls into question whether surgical handovers can be used to assess surgical trainees in the workplace.

工作场所评估已被外科培训机构广泛采用，以评估外科学员。在本研究中，我们使用切换工具来评估住院外科实习生的诊断准确性，以及这是否受到横断面成像的影响。方法：从前瞻性维护的数据库中回顾性回顾数据。我们回顾了979名患者在7个月期间的详细资料。主要结局是入院和出院诊断之间的一致性，使用手术交接工具记录。结果：住院诊断与出院诊断的符合率为81.4%。诊断准确性与转诊前横断影像呈正相关（r = 0.67）。在交接前进行CT扫描与更高的诊断准确率显著相关(p)。结论：横断成像对外科实习生的诊断准确率有积极影响。鉴于横断成像的可用性，这就提出了手术移交是否可以用于评估工作场所的外科受训者的问题。

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引用次数: 0

Twenty years of pancreatoduodenectomy at a tertiary low-volume hospital: A nationwide Icelandic study 二十年的胰十二指肠切除术在三级小容量医院：冰岛全国研究。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-05-05 DOI: 10.1016/j.surge.2025.04.051

Karin Johansen , Gudjón Birgisson , Kristín Huld Haraldsdóttir

Background

Due to its geographic isolation and limited population, Iceland inherently operates as a low-volume center for pancreatic surgery. To ensure high-quality health care, there is a long tradition of specialists training abroad. This retrospective cohort study aimed to evaluate pancreatic surgery outcomes in Iceland.

Methods

Patients who had undergone pancreatoduodenectomy in Iceland between 2003 and 2022 were included and compared between early (2003–2012) and late (2013–2022) periods.

Results

During the study period, 244 patients underwent a pancreatic procedure in Iceland, 122 of which were pancreatoduodenectomies. There was a notable increase in resection rates from the early to the late period, accompanied by significant reductions in the rates of pancreatic fistulas, postpancreatectomy hemorrhages, reoperations, length of hospital stay, and 30-day mortality. The rates of ideal outcome (54 %) and 90-day mortality (3 %) in the latter period were comparable to international rates. However, the total resection rates were low for the population size, and histopathological results revealed a high percentage of early-stage tumors.

Discussion

The findings of this retrospective study indicate a satisfactory standard of pancreatic surgery over the past decade, suggesting that the existing educational framework is effective. With continued careful preoperative evaluation, more patients could undergo pancreatic surgery in Iceland.

背景：由于地理上的隔离和人口的限制，冰岛天生就是一个小容量的胰腺手术中心。为了确保高质量的医疗保健，专家在国外接受培训有着悠久的传统。本回顾性队列研究旨在评估冰岛胰腺手术的结果。方法：纳入2003年至2022年在冰岛接受胰十二指肠切除术的患者，并将早期（2003-2012年）和晚期（2013-2022年）进行比较。结果：在研究期间，244例患者在冰岛接受了胰腺手术，其中122例为胰十二指肠切除术。从早期到晚期，切除率显著增加，同时胰腺瘘、胰腺切除术后出血、再手术、住院时间和30天死亡率显著降低。后期的理想转归率（54%）和90天死亡率（3%）与国际水平相当。然而，总切除率较低的人口规模，组织病理学结果显示，早期肿瘤的比例很高。讨论：这项回顾性研究的结果表明，在过去的十年中，胰腺手术的标准令人满意，表明现有的教育框架是有效的。通过持续的术前评估，更多的患者可以在冰岛接受胰腺手术。

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引用次数: 0

Corrigendum to “The positive effects of preoperative chlorhexidine rinse to reduce postoperative pneumonia after kidney transplantation surgery” [Surgeon. (2025) 23(1) 18–22] “术前氯己定冲洗减少肾移植术后肺炎的积极作用”的勘误表[外科医生。（2025） 23(1) 18-22]。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-05-05 DOI: 10.1016/j.surge.2025.04.001

Murat Ferhat Ferhatoglu , Osman Z. Sahin , Taner Kivilcim , Alp Gurkan

引用次数: 0

Strain on the surgeon: a systematic review of the methods of measuring strain in abdominal and thoracic surgery 外科医生的劳损：对胸腹外科手术中劳损测量方法的系统回顾。

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

Pub Date : 2025-04-30 DOI: 10.1016/j.surge.2025.04.015

Nainika Menon , Nadia Guidozzi , Sivesh Kathir Kamarajah , Rohan Gujjuri , Sheraz R. Markar

Introduction

Surgery can be arduous to the operating surgeon – both in terms of cognitive and physical strain. Ergonomic strain has been recognised to drive absenteeism, reduce career longevity and cause injuries.

This systematic review aims to 1. Outline the nature of ergonomic strain in the context of abdominal and thoracic surgery, regardless of surgical approach 2. Identify the qualitative and quantitative measures of surgical strain.

Methods

A systematic review was conducted using Pubmed, MEDLINE and Ovid EMBASE databases (date range: 1990 to Sep 2024). Of the initial 1288 articles identified, a final 71 studies were included in this review (quantitative measures = 36, qualitative measures = 49, of which 14 studies overlapped with the papers reviewed in the quantitative measures section).

Results

The quantitative measures used to measure ergonomic strain included electromyography, electrocardiography, gravimetric position sensors, skin conductance and inertial measurement units. Laparoscopic surgery caused less physical strain than open surgery, however more cognitive strain during the learning curve. Robotic surgery yielded conflicting data in terms of muscle activation when compared to laparoscopic surgery however reported less cognitive and cardiovascular strain. The qualitative measures of strain included a range of self-reported questionnaires, demonstrating important gender differences and scores that typically correlated with objective physical strain.

Discussion

The studies show wide variation in measuring ergonomic strain. Avenues for further research include measuring the impact of learning curves, patient factors on ergonomic strain and the impact of gender.

手术对外科医生来说可能是一项艰巨的工作——无论是在认知方面还是在体力方面。人体工程学压力被认为会导致旷工、缩短职业寿命并导致受伤。本系统综述旨在：1。概述在腹部和胸外科手术中，不论何种手术入路，人体工程学应变的性质。确定手术应变的定性和定量措施。方法：使用Pubmed、MEDLINE和Ovid EMBASE数据库（日期范围：1990年至2024年9月）进行系统评价。在最初确定的1288篇文章中，最终纳入了71项研究（定量测量= 36，定性测量= 49，其中14项研究与定量测量部分审查的论文重叠）。结果：测量人体工学应变的定量方法包括肌电图、心电图、重力位置传感器、皮肤电导和惯性测量单元。与开放手术相比，腹腔镜手术造成的身体压力更小，但在学习过程中认知压力更大。与腹腔镜手术相比，机器人手术在肌肉激活方面产生了相互矛盾的数据，但报告的认知和心血管压力较小。压力的定性测量包括一系列自我报告的问卷，显示出重要的性别差异和分数，通常与客观的身体压力相关。讨论：研究表明，在测量人体工程学应变方面存在很大差异。进一步研究的途径包括测量学习曲线的影响、患者因素对人体工程学压力的影响以及性别的影响。

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引用次数: 0